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Tag: payer relations


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Stakeholders push states to adopt federal policies

April 21, 2020HME News Staff

WASHINGTON - AAHomecare's payer relations team is involved in ongoing meetings and conversations in 46 states to encourage Medicaid to follow Medicare's lead in covering beneficiaries with acute respiratory conditions, and relaxing documentation, testing and other requirements during the coronavirus pandemic. The association has also developed a draft letter with extensive policy recommendations for state/regional associations to share with Medicaid officials nationwide. “AAHomecare will continue...

aahomecare, Coronavirus Outbreak, payer relations


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Smart Talk

Payer relations: Make your voice heard

April 6, 2020David Chandler

Q. What is the role of HME trade associations in payer relations efforts?A. Working with your state/regional association and AAHomecare can help you become more educated and engaged on payer relations issues. These associations represent the collective provider community, and provide input and advocate for HME policy priorities to a wide range of payers. Building relationships with government and commercial payers is a necessary function for associations so that when issues come up and solutions...

aahomecare, David Chandler, payer relations


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Smart Talk

Payer Relations: Choose the correct path

March 11, 2020David Chandler

Q. What are the pros and cons of solving state Medicaid issues with regulation vs. legislation?A. There are two principal paths to solving state Medicaid issues: either through regulation or legislation. Both are effective ways of resolving issues, but each comes with their own costs and benefits. It is typically a good idea to start with the regulatory approach so that you don't burn any bridges with state regulators and overlook any potential allies. However, I always recommend weighing the pros...

aahomecare, David Chandler, payer relations


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Payer Relations: Maintain working relationships

February 12, 2020David Chandler

Q. What are some of the most common problems faced when it comes to payer relations?A. Payer relations professionals face a wide range of problems on any given day, but the most common issues can be categorized under three main topics: working with Medicaid managed care organizations (MCOs), identifying who to contact at a payer, and determining the most efficient way to solve a problem with a payer. Knowing how to navigate these problems gives anyone in payer relations an advantage.The first issue...

aahomecare, David Chandler, payer relations


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Payer Relations: Establish a point person

January 8, 2020David Chandler

Q. What is payer relations and why is it so important?A. You may have contemplated this question and wondered why many companies are putting so many resources into this area. Simply put, payer relations (also referred to as payor relations by some) describes operations that work with a range of third-party payers to make sure patients have access to high quality equipment and care.  Payer relations goals can be accomplished in three general ways: by working directly with insurance companies,...

aahomecare, David Chandler, Home Medical Equipment, payer relations


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Mobility

Monroe Wheelchair works system

October 29, 2019Liz Beaulieu, Editor

SYRACUSE, N.Y. - With the rise of managed care organizations in Medicaid, especially in New York, it's been worth it for Monroe Wheelchair to have a contract relations manager on staff, Doug Westerdahl says.The company hired Rachel Herzog, who previously worked for a number of MCOs, for the role about two years ago.“I did it personally for years, but it got too much for me,” said Westerdahl, president. “She's on top of this stuff right away.”MCOs manage 83% of the Medicaid...

Managed Care, Medicaid, monroe wheelchair, payer relations


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AAH intensifies payer relations

July 26, 2019Liz Beaulieu, Editor

WASHINGTON - In its latest move to ramp up its payer relations efforts, AAHomecare is forming a new council and wrapping up a new toolkit.The association this month sent out invites to about 25 potential members for a Payer Relations Council to attend a first in-person meeting on Aug. 27.“Our councils do a lot of driving of initiatives and goals to help us with our successes,” said Laura Williard, vice president of payer relations for AAHomecare. “We've had a Regulatory Council,...

aahomecare, Humana Military, payer relations


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AAH meets with Humana Military on documentation glitch

July 16, 2019HME News Staff

WASHINGTON - AAHomecare has requested that Humana Military waive the requirement for documentation submission with each subsequent rental month after the initial documentation is received.Humana Military, which manages the Tricare East contract, is currently evaluating the request, the association says.The development comes after Laura Williard, vice president of payer relations, and David Chandler, director of payer relations, met with executive leadership at Humana Military and Wisconsin Physician...

aahomecare, Humana Military, payer relations, payment delays, TRICARE


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AAH: seeks payer relations professional, submits comments

December 27, 2018HME News Staff

WASHINGTON - AAHomecare is looking to add to its payer relations team. The association is recruiting a director of payer relations to join Laura Williard, vice president of payer relations. “As enrollment in Medicaid programs and in Medicare Advantage plans continues to rise, AAHomecare and our state association partners have been working non-stop to maintain sustainable reimbursement rates and to educate state legislators, regulators and plan administrators on the value of HME to their constituents,”...

aahomecare, comments, payer relations, templates, Vents


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Payer relations: Cures Act, state toolkit on agenda for 2019

December 14, 2018Theresa Flaherty, Managing Editor

WASHINGTON - The past year has been a busy one for AAHomecare's Laura Williard: She met with 28 states about Medicaid rates. 2019 is shaping up to be just as busy, she says.Per the 21st Century Cures Act, passed in late 2016, the federal portion of Medicaid reimbursement for HME cannot exceed what Medicare allows. States can either base their Medicaid rates on Medicare's lowest fee schedule; or they can gather aggregated data using their Medicaid rates and utilization rates by area for 2018.“We...

aahomecare, Cures Act reconciliation, Laura Williard, payer relations


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